Common cold
Common cold: Excerpt from Professional Guide to Diseases (Eighth Edition)
The common cold (also known as acute coryza) is an acute, usually afebrile viral infection that causes inflammation of the upper respiratory tract. It's the most common infectious disease, accounting for more time lost from school or work than any other cause. Although a cold is benign and self-limiting, it can lead to secondary bacterial infections.
Causes and incidence
About 90% of colds stem from a viral infection of the upper respiratory passages and consequent mucous membrane inflammation; occasionally, colds result from a mycoplasmal infection. (See What happens in the common cold.)
Over a hundred viruses can cause the common cold. Major offenders include rhinoviruses, coronaviruses, myxoviruses, adenoviruses, coxsackieviruses, and echo-viruses.
Transmission occurs through airborne respiratory droplets, contact with contaminated objects, and hand-to-hand transmission. Children acquire new strains from their schoolmates and pass them on to family members. Fatigue or drafts don't increase susceptibility.
The common cold is more prevalent in children than in adults; in adolescent boys than in girls; and in women than in men. In temperate zones, it's more common in the colder months; in the tropics, during the rainy season.
Signs and symptoms
After a 1- to 4-day incubation period, the common cold produces pharyngitis, nasal congestion, coryza, headache, and burning, watery eyes. Additional effects may include fever (in children), chills, myalgia, arthralgia, malaise, lethargy, and a hacking, nonproductive, or nocturnal cough.
As the cold progresses, clinical features develop more fully. After a day, symptoms include a feeling of fullness with a copious nasal discharge that commonly irritates the nose, adding to discomfort. About 3 days after onset, major signs diminish, but the “stuffed up” feeling generally persists for about a week. Reinfection (with productive cough) is common, but complications (sinusitis, otitis media, pharyngitis, and lower respiratory tract infection) are rare. A cold is communicable for 2 to 3 days after the onset of symptoms.
Diagnosis
No explicit diagnostic test exists to isolate the specific organism responsible for the common cold. Consequently, diagnosis rests on the typically mild, localized, and afebrile upper respiratory symptoms. Despite infection, white blood cell counts and differential are within normal limits. Diagnosis must rule out allergic rhinitis, measles, rubella, and other disorders that produce similar early symptoms. A temperature higher than 100° F (37.8° C), severe malaise, anorexia, tachycardia, exudate on the tonsils or throat, petechiae, and tender lymph glands may point to more serious disorders and require additional diagnostic tests.
Treatment
The primary treatments — aspirin, acetaminophen or ibuprofen, fluids, and rest — are purely symptomatic because the common cold has no cure. Aspirin eases myalgia and headache; fluids help loosen accumulated respiratory secretions and maintain hydration; and rest combats fatigue and weakness. In a child with a fever, acetaminophen is the drug of choice.
Decongestants can relieve congestion, and throat lozenges relieve soreness. Steam encourages expectoration. Nasal douching, sinus drainage, and antibiotics aren't necessary except in complications or chronic illness. Pure antitussives relieve severe coughs but are contraindicated in productive coughs, when cough suppression is harmful. The role of vitamin C remains controversial. In infants, saline nose drops and mucus aspiration with a bulb syringe may be beneficial.
Special considerations
❑Emphasize that antibiotics don’t cure the common cold.
❑Tell the patient to maintain bed rest during the first few days, to use a lubricant on his nostrils to decrease irritation, to relieve throat irritation with hard candy or cough drops, to increase fluid intake, and to eat light meals.
❑Warm baths or heating pads can reduce aches and pains but won’t hasten a cure. Suggest hot- or cold-steam vaporizers. Commercial expectorants are available, but their effectiveness is questionable.
❑Advise against overuse of nose drops or sprays because they may cause rebound congestion.
❑To help prevent colds, warn the patient to minimize contact with people who have colds. To avoid spreading colds, teach the patient to wash his hands often and before touching his eyes, to cover coughs and sneezes, and to avoid sharing towels and drinking glasses.
Pictures
Book Source Details
- Book Title: Professional Guide to Diseases (Eighth Edition)
- Author(s): Springhouse
- Year of Publication: 2005
- Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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